Progressive Changes Research Articles

Health Care Stereotype Threat and Sexual and Gender Minority Well-Being.

Sexual and gender minorities (SGMs) have experienced progressive change over the last 50 years. However, this group still reports worse health and health care experiences. An innovative survey instrument that applies stereotype threat to the health care setting, health care stereotype threat (HCST), offers a new avenue to examine these disparities. We harmonized two national probability data sets of SGMs-Generations and TransPop-capturing 503 gay men, 297 lesbians, 467 bisexuals, and 221 trans people. Using these data, we, first, explored how HCST's association with self-rated health and psychological distress changed while considering more established constructs: discrimination and stigma. Second, we examined how HCST's association varied across SGM groups. Results suggest that HCST is a unique predictor net of the associations with discrimination and stigma. Furthermore, results highlight the more consequential associations for trans people on well-being compared to gay men. We discuss implications of these findings for future research and potential interventions.

Progressive mechanical and structural changes in anterior cerebral arteries with Alzheimer’s disease

Alzheimer's disease (AD) is a neurodegenerative disease and the main cause for dementia. The irreversible neurodegeneration leads to a gradual loss of brain function characterized predominantly by memory loss. Cerebrovascular changes are common neuropathologic findings in aged subjects with dementia. Cerebrovascular integrity is critical for proper metabolism and perfusion of the brain, as cerebrovascular remodeling may render the brain more susceptible to pulse pressure and may be associated with poorer cognitive performance and greater risk of cerebrovascular events. The objective of this study is to provide understanding of cerebrovascular remodeling with AD progression. Anterior cerebral arteries (ACAs) from a total of 19 brain donor participants from controls and pathologically diagnosed AD groups (early—Braak stages I-II; intermediate—Braak stages III-IV; and advanced—Braak stages V-VI) were included in this study. Mechanical testing, histology, advanced optical imaging, and mass spectrometry were performed to study the progressive structural and functional changes of ACAs with AD progression. Biaxial extension-inflation tests showed that ACAs became progressively less compliant, and the longitudinal stress in the intermediate and advanced AD groups was significantly higher than that from the control group. With pathological AD development, the inner and outer diameters of the ACAs remained almost unchanged; however, histology study revealed progressive smooth muscle cell atrophy and loss of elastic fibers which led to compromised structural integrity of the arterial wall. Multiphoton imaging demonstrated elastin degradation at the media-adventitia interface, which led to the formation of an empty band of 21.0 ± 15.4 μm and 32.8 ± 9.24 μm in width for the intermediate and advanced AD groups, respectively. Furthermore, quantitative birefringence microscopy showed disorganized adventitial collagen with AD development. Mass spectrometry analysis provided further evidence of altered collagen content and other extracellular matrix (ECM) molecule and smooth muscle cell changes that were consistent with the mechanical and structural alterations. Collectively, our study provides understanding of the mechanical and structural cerebrovascular deterioration in cerebral arteries with AD, which may be related to neurodegenration and pathology in the brain.

Assessment of hematological indicators, histological alterations, and DNA damage in Danube sturgeon (Acipenser gueldenstaedtii) exposed to the organophosphate malathion

This study focused on organophosphate malathion toxicity in Danube sturgeon (Acipenser gueldenstaedtii) and its negative effects in sub-lethal concentration. In this context, the LC50 value of fish exposed to five different concentrations and two different sub-lethal concentrations depending on the LC50 value were considered. Accordingly, LC50 of malathion for 96 h was 3.24 mg L-1. In leukocyte (WBC) and hemoglobin (HGB) such as hematological indicators, significant differences were observed in sub-lethal concentration (One-eighth of the LC50 =0.4 mg L-1). In addition, serious histological alterations were observed in the gill and liver tissues after both acute (96 h) and chronic periods (28 days). While epithelial lifting and hyperplasia were the most prominent lesions in the gill, intense vacuolization were observed in the liver. In addition, circulatory disturbances, regressive changes, and progressive changes in the gill and circulatory disturbances and inflammation in the liver were significantly higher for the chronic period. Finally, significantly higher DNA damage was detected in fish exposed malathion in the chronic period compared to the control group. In conclusion, the present study has proven that malathion has a hematological, histological and genotoxic effect on the endangered species A. gueldenstaedtii. Thus, the current study will motivate for residue studies on A. gueldenstaedtii and trigger conservation strategies for local governments.

Metabolic biomarkers for Alzheimer's disease: A mini review

Alzheimer's disease (AD) is the most common neurodegenerative disorder and a leading cause of dementia worldwide, which characterized by progressive cognitive decline, memory impairment, and changes in behavior and personality. The prevalence of AD is expected to rise significantly in the coming decades due to the aging population, making it a major public health concern. Mounting evidence suggests that metabolic dysregulation plays a critical role in the pathogenesis of AD. In this mini review, we provide an overview of the current understanding of the interplay between metabolism and AD. Specifically, we explore the dysregulation of glucose metabolism, lipid metabolism, amino acid metabolism, and nitrogen oxide synthesis pathways in AD. These metabolic alterations have been identified as potential biomarkers for early diagnosis and prognosis of AD. Additionally, we discuss the current status of research in this field, including the advancements in metabolomics and imaging techniques that have allowed for the identification and validation of metabolic biomarkers.

Before reflexivity comes preflexivity

Before reflexivity comes preflexivity

Chondral Injury Associated With ACL Injury: Assessing Progressive Chondral Degeneration With Morphologic and Quantitative MRI Techniques.

Anterior cruciate ligament (ACL) injuries are associated with a risk of post-traumatic osteoarthritis due to chondral damage. Magnetic resonance imaging (MRI) techniques provide excellent visualization and assessment of cartilage and can detect subtle and early chondral damage. This is often preceding clinical and radiographic post-traumatic osteoarthritis. Morphologic and quantitative MRI techniques can assess early and progressive degenerative chondral changes after acute ACL injury. Prospective longitudinal cohort. Level 3. Sixty-five participants with acute unilateral ACL injuries underwent bilateral knee MRI scans within 1 month of injury. Fifty-seven participants presented at 6 months, while 54 were evaluated at 12 months. MRI morphologic evaluation using a modified Noyes score assessed cartilage signal alteration, chondral damage, and subchondral bone status. Quantitative T1ρ and T2 mapping at standardized anatomic locations in both knees was assessed. Participant-reported outcomes at follow-up time points were recorded. Baseline Noyes scores of MRI detectable cartilage damage were highest in the injured knee lateral tibial plateau (mean 2.5, standard error (SE) 0.20, P < 0.01), followed by lateral femoral condyle (mean 2.1, SE 0.18, P < 0.01), which progressed after 1 year. Longitudinal prolongation at 12 months in the injured knees was significant for T1ρ affecting the medial and lateral femoral condyles (P < 0.01) and trochlea (P < 0.01), whereas T2 values were prolonged for medial and lateral femoral condyles (P < 0.01) and trochlea (P < 0.01). The contralateral noninjured knees also demonstrated T1ρ and T2 prolongation in the medial and lateral compartment chondral subdivisions. Progressive chondral damage occurred despite improved patient-reported outcomes. After ACL injury, initial and sustained chondral damage predominantly affects the lateral tibiofemoral compartment, but longitudinal chondral degeneration also occurred in other compartments of the injured and contralateral knee. Early identification of chondral degeneration post-ACL injury using morphological and quantitative MRI techniques could enable interventions to be implemented early to prevent or delay PTOA.

The influence of football classes on the physical fitness of young men

The purpose of the study: to determine changes in the indicators of physical fitness of 16-17-year-old boys under the influence of football lessons. Research material and methods. A pedagogical experiment was conducted to determine changes in physical fitness indicators of 16-17-year-old boys under the influence of football lessons. During the pedagogical experiment, control and experimental groups were formed. All young men belonged to the main medical group. In this experiment, informed consent was obtained from all participants. 104 higher education students of LNTU participated in the pedagogical experiment. To implement research tasks, we used the following methods: analysis of scientific and methodical literature; sociological research methods; pedagogical observation; pedagogical experiment; methods of mathematical statistics. The results. The data show that the largest group of respondents has a high level of interest in football (CG – 46.2%, EG – 85.6%). 37.4% of the surveyed young men of the CG and 14.4% of the EG have an average level of interest. The fact remains that there was not a single young man who chose the option - low or no interest or negative attitude towards football activities among the EG respondents. The highest percentage of EG respondents received the motive to improve their health (47.2%). In CG, 40.3% of young men chose the option to receive credit (40.3%). Such motives as: mastering the technique of physical exercises, interest in the personality of the teacher and the desire to communicate with friends did not find their supporters. The dynamics of growth rates of the physical fitness indicators of the participants of the pedagogical experiment during the research period shows that the greatest progressive changes were achieved in the indicators of strength, endurance and speed-power qualities.&#x0D; Conclusion. Our study showed that the improvement in the physical fitness indicators of students who play football took place in the participants of the EG. It can be argued that the proposed means and measures for improving physical fitness are effective.

Spectroscopic study of drug–drug interactions: influence of two over-the-counter drugs on the albumin binding affinities of carbamazepine and its major metabolite

BackgroundMultidrug regimens can increase the risk of drug–drug interactions at the level of albumin binding especially for drugs with narrow therapeutic windows such as carbamazepine (CBZ). This risk is particularly heightened for CBZ which is mainly metabolized to the active carbamazepine-10,11-epoxide (CBZE) that has been identified as contributory to both the therapeutic efficacy and severity of toxicity in CBZ-treated individuals. The objective of this study was to investigate the binding affinities of albumin with CBZ and CBZE, and to explore the influence of two competing over-the-counter medicines on the binding characteristics. CBZE was synthesized by epoxidation of CBZ and characterized using IR, NMR and mass spectrometry. The influence of paracetamol and ascorbic acid on the albumin complexes of CBZ and CBZE was investigated using absorption and IR spectrophotometry.ResultsProtein–ligand complexation produced progressive hyperchromic changes in 278 nm band of bovine serum albumin (BSA) with formation constants of 10.28–10.44 and 12.66–13.02 M−1 for CBZ and CBZE, respectively. Thermodynamic considerations confirmed both binding processes as endothermic, spontaneous and driven by hydrophobic interactions. The presence of ascorbic acid increased the binding constants of both CBZ-BSA and CBZE-BSA complexes by non-competitive interference mechanism. Similarly, paracetamol increased the affinity of CBZ for albumin but then competitively interfered with the CBZE-BSA complex. The ratio of albumin binding affinities of CBZ–CBZE varied from 0.81 in the absence of competing drug to 1.29 and 1.0 with paracetamol and ascorbic acid, respectively. IR study confirmed that both CBZ and CBZE induced a reduction from the 67.34% α-helical content of free BSA to 42.56 and 56.43%, respectively. Competitive binding in the presence of either paracetamol or ascorbic acid induced further reduction in the α-helical content of BSA in the complexes. The most extensive perturbation in the secondary structure of BSA (22.78% α-helical content) which was observed with CBZE-BSA complex in the presence of paracetamol is probably due to the increased interaction of the protein for the analgesic.ConclusionThe study has revealed potential interference of paracetamol or ascorbic acid with the albumin binding of carbamazepine and its major metabolite.

Acute Exposure to Two Biocides Causes Morphological and Molecular Changes in the Gill Ciliary Epithelium of the Invasive Golden Mussel Limnoperna fortunei (Dunker, 1857).

Limnoperna fortunei, the golden mussel, is a bivalve mollusk considered an invader in South America. This species is responsible for ecological and economic damages due to its voluminous fouling capability. Chemical biocides such as MXD-100™ and sodium dichloroisocyanurate (NaDCC) are often used to control L. fortunei infestations in hydraulic systems. Thus, we proposed to investigate the effects of different periods (24, 48 and 72 h) of exposure to MXD-100™ (0.56 mg L-1) and NaDCC (1.5 mg L-1) on the gills of L. fortunei through morphological and molecular analyses. NaDCC promoted progressive morphological changes during the analyzed periods and only an upregulation of SOD and HSP70 expression during the first 24 h of exposure. MXD-100™ led to severe morphological changes from the first period of exposure, in addition to an upregulation of SOD, CAT, HSP70 and CYP expression during the first 24 h. In contrast, MXD-100™ led to a downregulation of CAT transcription between 24 and 48 h. In static conditions, NaDCC causes lethal damage after 72 h of exposure, and that exposure needs to be continuous to achieve the control of the species. Meanwhile, the MXD-100™ treatment presented several effects during the first 24 h, showing acute toxicity in a shorter period of time.

Prenatal features of aneurysm of the posterior cerebral artery: a case report

BackgroundFetal cerebral aneurysm other than aneurysm of vein of Galen aneurysmal malformation (VGAM) is extremely rare. This report describes prenatal features of aneurysm of the posterior cerebral artery (APCA) with rapid progression and its natural intrauterine course of the disease, which has never been reported.Case presentationThis is the first report of prenatal features of APCA, detected at 34–36 weeks of gestation, simulating choroid plexus cyst or arachnoid cyst. The diagnosis was based on color flow ultrasound with tracing along the course of cerebral arteries. Also, rendered 3D color flow ultrasound was helpful in demonstrating course of the vessels feeding the aneurysm and supporting the diagnosis. The aneurysm showed nature of rapidly progressive changes, leading to leakage resulting in intracerebral and intraventricular hemorrhage as well as high output state associated with anemia. Prenatal diagnosis and management are very challenging. This case ended up with planned delivery at 37 weeks, giving birth to a surviving male newborn, weighing 2600 g. The neonatal CT brain scans and CTA confirmed the prenatal findings. The prognosis was relatively poor because of extensive intracerebral hemorrhage with severe hydrocephalus and brain midline shift. The couple opted for neonatal palliative care without neurosurgical correction.ConclusionThis study demonstrate that the most important tool for prenatal diagnosis is color Doppler ultrasound, which will demonstrate turbulent blood flow. Three-dimension color Doppler ultrasound is helpful in supporting the diagnosis. The case presented here suggests that the disease has a natural course of rapid progression and massive brain destruction or high output congestive heart failure can be expected.

Hippocampal tandem mass tag (TMT) proteomics analysis during kindling epileptogenesis in rat

Epilepsy is a neurological disorder that remains difficult to treat due to the lack of a clear molecular mechanism and incomplete understanding of involved proteins. To identify potential therapeutic targets, it is important to gain insight into changes in protein expression patterns related to epileptogenesis. One promising approach is to analyze proteomic data, which can provide valuable information about these changes.In this study, to evaluate the changes in gene expression during epileptogenesis, LC-MC2 analysis was carried out on hippocampus during stages of electrical kindling in rat models. Subsequently, progressive changes in the expression of proteins were detected as a result of epileptogenesis development. In line with behavioral kindled seizure stages and according to the proteomics data, we described epileptogenesis phases by comparing Stage3 versus Control (S3/C0), Stage5 versus Stage3 (S5/S3), and Stage5 versus Control group (S5/C0). Gene ontology analysis on differentially expressed proteins (DEPs) showed significant changes of proteins involved in immune responses like Csf1R, Aif1 and Stat1 during S3/C0, regulation of synaptic plasticity like Bdnf, Rac1, CaMK, Cdc42 and P38 during S5/S3, and nervous system development throughout S5/C0 like Bdnd, Kcc2 and Slc1a3.There were also proteins like Cox2, which were altered commonly among all three phases.The pathway enrichment analysis of DEPs was also done to discover molecular connections between phases and we have found that the targets like Csf1R, Bdnf and Cox2 were analyzed throughout all three phases were highly involved in the PPI network analysis as hub nodes. Additionally, these same targets underwent changes which were confirmed through Western blotting. Our results have identified proteomic patterns that could shed light on the molecular mechanisms underlying epileptogenesis which may allow for novel targeted therapeutic strategies.

Precursor lesions of lung tumors

Lung cancer is the leading cause of cancer deaths globally with many new cases diagnosed each year. Recent studies have shown that an accumulation of various genetic abnormalities results in progressive morphologic changes in bronchial epithelium. Such changes are part of the continuum from precursor lesions to invasive lung cancers. Improvement in diagnostic modalities has made the detection of such preneoplastic lesions possible and resection at this stage confer excellent prognosis. The World Health Organization (WHO) has recognized atypical adenomatous hyperplasia/ adenocarcinoma in situ, squamous dysplasia/ squamous cell carcinoma in situ, and diffuse idiopathic pulmonary neuroendocrine cell hyperplasia as the precursor lesions of adenocarcinoma, squamous cell carcinoma, and carcinoid tumors respectively. This review summarizes the key features of these preneoplastic lesions based on the current understanding and knowledge.

Introduction to grid‐scale battery energy storage system concepts and fire hazards

AbstractAs the world continues to enact progressive climate change targets, renewable energy solutions are needed to achieve these goals. One such solution is large‐scale lithium‐ion battery (LIB) energy storage systems which are at the forefront in ensuring that solar‐ and wind‐generated power is delivered when the grids need it most. However, the perceived hazards of LIBs due to recent events in the United States and Australia pose a risk to their future success. When a battery energy storage system (BESS) has a multilayered approach to safety, the thermal runaway, fire, and explosion hazards can be mitigated. Successful implementation of this approach requires cooperation, collaboration, and education across all stakeholder groups to break down these preconceived notions. Much can be learned from the recent BESS fire and explosion events to inform safer design and operation. These events and their contributing factors share many commonalities with historic losses in the hydrocarbon industry. Fire and process safety engineers who have traditionally worked in the hydrocarbon industry can be of immense value to the BESS industry.

Perspectives of the offshore CCS development in the polish EEZ on a Baltic Sea: insights from ongoing preliminary research for pilot CO2 injection

The key to effectively combatting progressive climate change lies in promptly reducing greenhouse gas (GHG) emissions, particularly carbon dioxide (CO2), whose concentration continues to rise due to human activities. The European Union (EU) has established legally binding targets, including achieving climate neutrality by 2050, with an intermediate goal of reducing GHG emissions by 55 % by 2030 compared to 1990 levels. Poland, one of the major CO2 emitters in Europe, also possesses significant storage potential in terms of projected CO2 capacity within its sedimentary basins. Considering this, the implementation of Carbon Capture and Storage (CCS) technology could play a crucial role in Poland's efforts to decarbonize its economy. For several years, the Oil and Gas Institute – National Research Institute (INiG – PIB) has been at the forefront of domestic research activities concerning underground CO2 injection. The involvement dates back to 1996 by pioneering the development of a concept, design, and implementation of one of Europe's earliest industrial installations for reinjecting acid gas, consisting of approximately 80 % CO2 and 20 % H2S, into the reservoir water underlying a productive natural gas field. This facility in Borzęcin operated by PGNiG (now part of ORLEN GROUP), is a unique testing ground where the injection process has been running continuously for 27 years. The research conducted at INiG – PIB has played an important role in identifying appropriate geological structures in Poland with a total storage capacity of 10-15 Gt CO2. Around 90-93 % of the CO2 storage capacity is found in saline aquifers, with a significant portion of approximately 7-10 % identified within mature hydrocarbon fields.Despite recent progress in managing industrial CO2 emissions, the peace of CCS development falls short of meeting the objectives set by the Paris Agreement. The main hindrance lies in the absence of a suitable regulatory framework for CO2 transport and storage infrastructure. Recognizing this challenge, the national offshore operator, Lotos Petrobaltic (LPB), presented in 2021 a Green Paper on CCS development in Poland. This document outlines a set of recommendations for legislative alternations to facilitate the initiation of large-scale, commercial CCS projects within the country. Given the current national regulations and assumptions regarding low social barriers, the most expeditious approach to implementing a First-of-a-Kind (FOAK) large-scale CCS project in Poland seems to involve deploying depleted hydrocarbon reservoirs located at the Polish Exclusive Economic Zone (EEZ) within the Baltic Sea. The LPB, with research and scientific support from INiG – PIB, has launched a program aimed at conducting a preliminary assessment of CO2 injection in Middle Cambrian sandstones. The project is scheduled to begin with a pilot injection into the well-identified, depleted structure of the B3 oil reservoir. Subsequently, it may be expanded to include adjacent hydrocarbon reservoirs and could ultimately encompass the entire Cambrian aquifer.The Cambrian aquifer is characterized by complex tectonics, comprising several blocks separated by fault zones. These fault zones may act as barriers to the propagation of reservoir fluids, as demonstrated by the presence of hydrocarbon traps in the vicinity of some fault zones.The B3 oil field, covering an area of 36,2 km2, is an elongated SW-NE, asymmetric anticline, cut on the west side by an inverted fault zone. The reservoir interval, with an average depth of 1450 meters below sea level comprises of sandstones of the Paradoxides Paradoxissimus (Middle Cambrian Zone) horizon showing a monoclinal dip towards the south-east. The reservoir formation exhibits heterogeneity in both within the vertical profile and the horizontal direction, characterized by a wide range of petrophysical parameters values. According to preliminary assessments, the CO2 storage capacity of the B3 site is estimated to be around 7 Mt CO2. The expansion of CO2 storage to the remaining hydrocarbon fields and the overarching Cambrian aquifer megastructure could potentially increase the total storage capacity to more than 150 Mt. The envisioned CO2 sources include emitters from the chemical industry, where CO2 is a by-product of the fertilizer production process. During the project’s pilot phase, the predicted CO2 injection rate is expected to be between 25-50 kt CO2 per year. As the project transitions to the upscaled phase, the injection rate is projected to increase significantly, reaching approximately 2 Mt CO2 per year. The transportation of CO2 for full-scale injection is planned through multimodal means, considering potential synergies with the multimodal CO2 Terminal in Gdansk, which is being planned under the ECO2CEE project (formerly EU CCS Interconnector). A pipeline connection between the offshore storage area and the CO2 Terminal is under consideration.The main research problems addressed within the INiG – PIB and LPB joint initiative include determining the sequestration potential of the Cm2pp aquifer, assessing the feasibility of the CO2-EOR process, recognizing the effects of injected CO2/reservoir rock/caprock interactions on injectivity, geomechanical parameters, and sealing integrity, as well as investigating CO2-induced corrosion of steel components in the transport and injection plant.

μ-opioid receptor agonists and psychedelics: pharmacological opportunities and challenges.

Opioid misuse and opioid-involved overdose deaths are a massive public health problem involving the intertwined misuse of prescription opioids for pain management with the emergence of extremely potent fentanyl derivatives, sold as standalone products or adulterants in counterfeit prescription opioids or heroin. The incidence of repeated opioid overdose events indicates a problematic use pattern consistent with the development of the medical condition of opioid use disorder (OUD). Prescription and illicit opioids reduce pain perception by activating µ-opioid receptors (MOR) localized to the central nervous system (CNS). Dysregulation of meso-corticolimbic circuitry that subserves reward and adaptive behaviors is fundamentally involved in the progressive behavioral changes that promote and are consequent to OUD. Although opioid-induced analgesia and the rewarding effects of abused opioids are primarily mediated through MOR activation, serotonin (5-HT) is an important contributor to the pharmacology of opioid abused drugs (including heroin and prescription opioids) and OUD. There is a recent resurgence of interest into psychedelic compounds that act primarily through the 5-HT2A receptor (5-HT 2A R) as a new frontier in combatting such diseases (e.g., depression, anxiety, and substance use disorders). Emerging data suggest that the MOR and 5-HT2AR crosstalk at the cellular level and within key nodes of OUD circuitry, highlighting a major opportunity for novel pharmacological intervention for OUD. There is an important gap in the preclinical profiling of psychedelic 5-HT2AR agonists in OUD models. Further, as these molecules carry risks, additional analyses of the profiles of non-hallucinogenic 5-HT2AR agonists and/or 5-HT2AR positive allosteric modulators may provide a new pathway for 5-HT2AR therapeutics. In this review, we discuss the opportunities and challenges associated with utilizing 5-HT2AR agonists as therapeutics for OUD.

Choroidal vessel density in major depressive disorder using swept-source optical coherence tomography angiography

BackgroundPrevious studies have revealed the retinal structural impairment in major depressive disorder (MDD). The choroid is more affected by systemic changes compared to the retina and provides nutrients to the retina. It is uncertain whether the choroidal structure was damaged in MDD. Therefore, this study aimed to investigate choroidal vessel density (VD) in MDD patients using swept-source optical coherence tomography angiography (SS-OCTA). MethodsThis study investigated the choroidal and retinal VD of subjects with SS-OCTA. MDD was identified based on the Diagnostic and International Classification of Diseases, 10th edition (ICD-10). The VD was automatically calculated as the ratio of the pixel areas of the vessels divided by the total area of the regions by the device. ResultsCompared with healthy controls (HCs) (n = 45 eyes), the MDD group (n = 66 eyes) demonstrated significantly lower supranasal and temporal choroidal vessel volume (CVV), temporal choroidal vessel volume index (CVI), and supranasal and temporal choroidal stroma volume (CSV) (all p < 0.05). After adjustment for age and sex, we found that temporal CVV (β = −9.31, p = 0.040) and supranasal (β = −15.28, p = 0.034) and temporal CSV (β = −11.82, p = 0.036) were significantly associated with MDD. Both choroidal thickness and retinal VD indicators did not differ significantly between MDD patients and HCs (both p > 0.05). LimitationsConclusions about progressive changes in choroidal vascular structures during the course of MDD are limited by the our cross-sectional study. ConclusionsWe found the choroidal VD in MDD was lower compared with HCs, which suggests that decreased choroidal VD is associated with the MDD.

Increasing Soluble P-Selectin Levels Predict Higher Peripheral Atherosclerotic Plaque Progression.

The adhesion molecule P-selectin is expressed by endothelial cells and platelets. It is involved in platelet activation and leukocyte adhesion, both important processes in the pathogenesis of atherosclerosis. Our study was designed to assess the predictive value of soluble P-selectin (sP-selectin) on the progression of peripheral atherosclerosis. This is an observational, single-center, cohort study that included 443 patients with established cardiovascular disease (CVD) or at least one cardiovascular risk factor. Over a period of 4 years, each patient underwent three-dimensional (3D) ultrasound to assess the plaque volume of the carotid and femoral arteries once per year. In addition, plasma sP-selectin levels were measured at each visit. The association between changes in sP-selectin and peripheral atherosclerotic plaque progression was assessed using growth curve models. 338 patients were available for statistical analysis. Each standard deviation increase in sP-selectin was significantly (p < 0.001) associated with a 46.09 mm3 higher plaque volume. In ROC-analysis, changes in sP-selectin over time showed an optimal cut-off value around Δ 0.0 µg/mL sP-selectin and significantly improved the predictive value of the ESC-SCORE (AUC for the combination of both parameters was 0.75 (95% CI 0.68-0.81, p < 0.001). Patients with increasing sP-selectin showed a significantly higher plaque progression compared to patients with decreasing or stable sP-selectin levels (202 mm3 vs. 110 mm3, p < 0.001). Increasing sP-selectin levels can predict higher atherosclerotic plaque progression as measured by 3D ultrasound. We suggest serial measurements of sP-selectin as an easily measurable biomarker for peripheral atherosclerotic plaque progression.

Bacterial infections of the skin in the context of climate change and migration

In the context of climate change and migration, both common and previously less common pathogens are gaining importance as cutaneous bacterial infections. To inform medical professionals about challenges to dermatology posed by climate change and migration. Review of the current literature on emerging antimicrobial resistance and emerging pathogens in general and on the epidemiological situation in Germany in particular. Climate change has adirect impact on microbiological ecosystems in Germany's warming coastal waters leading to an increase of marine V.vulnificus counts and human infections. Secondary to global warming, transmitting vectors of, for example, Lyme disease, rickettsioses and tularemia are also increasing. In addition, infectious diseases like cutaneous diphtheria and mycobacteriosis have been diagnosed in migrants, mostly likely acquired before migration or on the migration route and first diagnosed in Germany. In this context, antimicrobial resistance (e.g. methicillin-resistant Staphylococcus aureus [MRSA] and multidrug-resistant gram-negative bacteria) is gaining importance. Due to progressive changes in global climate and ongoing migration, the aforementioned pathogens of infectious skin diseases and changes in antimicrobial resistance patterns have to be expected. Physicians should be aware of these developments in order to offer appropriate diagnostics and treatment. Epidemiological and biogeographic monitoring will be indispensable for managing emerging changes.

The extracapsular dissection technique in the management of benign tumours of the parotid gland: our experience in 194 patients.

The indications for and approaches to extracapsular dissection for parotid gland benign tumours are debated in the literature. This study retrospectively evaluates a single site's short- and long-term results with a standardised extracapsular dissection approach to benign parotid tumours. A retrospective review of a single institution's records identified cases with extracapsular dissection as the primary surgery for non-recurrent benign parotid tumours. A total of 194 eligible patients were identified (124 women and 70 men, age 47.75 ± 15.62 years). Pre-, intra- and post-surgical data were reviewed for complications and recurrences. Histology reported pleomorphic adenoma in 165 patients, Warthin's tumour in 28 patients and both in one patient. Mean follow up was 36 ± 16 months (range, 12-84 months). The incidences of complications following extracapsular dissection were temporary (n = 13) and permanent (n = 0) facial nerve dysfunction, Frey's syndrome (n = 1)) and recurrences (n = 5). These rates align with prior literature. This case series shows how a standardised approach to extracapsular dissection for benign parotid tumours yields favourable results, supporting a progressive change of strategy towards reduced invasiveness.

A - 27 Early-Onset Alzheimer's Disease: Indications of Psychosis Severity and Disease Progression.

Early-onset Alzheimer's disease (EOAD) comprises about 5% of ad cases and is associated with delays in diagnosis and aggressive course. Psychotic symptoms are frequent in ad and often include delusions of infidelity and hallucinations. When present, ad with psychosis is accompanied by elevated levels of depression and greater functional impairment. This case expands upon the existing literature on EOAD through the timeline of a complex psychosis presentation accompanied by rapid cognitive decline. 63-year-old, Hispanic, woman with progressive cognitive changes (e.g., confusion, forgetfulness, word-finding difficulties, disorganization) that emerged 5years prior to seeking neurological consultation. Psychosis symptoms (i.e., auditory/visual hallucinations, delusions), in the context of real events (i.e., husband's previous infidelity), developed simultaneously. These pervasive symptoms have contributed to social withdrawal, persistent suicidal tendencies, and impaired IADLs. Neuroimaging suggested hypometabolism in the parietotemporal regions with precuneus and posterior cingulate gyri involvement. The evaluation revealed fairly generalized cognitive decline. Basic attention, working memory, visual abstract reasoning, and phonemic fluency were intact. Visual integration/visuoconstruction were reduced. Impairments emerged in processing speed, rapid cognitive flexibility, cognitive inhibition, conceptualization, visuospatial orientation, semantic fluency, confrontation naming, and visual and verbal encoding and retention (with rapid forgetting). She endorsed moderately elevated symptoms of depression and anxiety. The pattern of cognitive and functional deficits are all suggestive of an ad process. Her age, sex, significant neuroimaging findings, report of earliest cognitive symptoms, and family history reinforce an EOAD etiology. Significant behavioral changes are often associated with increased cognitive impairment and in turn, may mark the progression/stage of the disease.